Monday, April 8, 2013

Fear Is Like Ice Cream

My mobile rings at least fifty times a day My pager buzzes double that. I'm stopped in the hall and accosted by doctors, nurses, patients and families. And most of the questions are mundane: an adjustment of the coumadin dose, a formulary change for the antibiotic. Thousands of daily decisions reasoned through years of experience and practice. This is the life of the modern day Internist.

Yet, I can't help but admit that I'm always waiting for the other shoe to drop. Each ring, each buzz, carries the possibility of disaster. Will it be the ER with a hypotensive octogenarian, or the nursing home reporting a patient has been put on a nonrebreathing mask. Or worst of all, a young person with real chest pain and shortness of breath.

I'd be lying if I said it didn't have an affect. Fear, to me, is like ice cream. No matter how often you taste it, you can't help but quiver each time the frozen tundra meets your lips. Unfortunately, the Pavlovian nature of the human conscious can be quite indiscriminate. Sometimes we react to the stimulus in the absence of need. My body jumps awake to the vibrating pager clipped to my waste. I yell into the phone at the poor nurse reporting a skin tear or fall.

This reality can be tiring. The over stimulation of the senses and lack of sleep mean that surprises at the end of the day can be particularly challenging. So when my phone rang this afternoon while waiting for my daughter to finish her ice skating practice, I jerked to attention and fumbled to pick up.

It was Mrs. Morris calling for the third time to inquire about her husband's place on the transplant list. I reflexively began to explain again how, as the internist, I had very little power to dictate how long it would be. But she couldn't wait for my soliloquy to end and cut me short.